Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T10:33:56.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of Outcome Predictors after First Attack of Optic Neuritis

Published online by Cambridge University Press:  02 December 2014

Mansoureh Mamarabadi ,
Hadie Razjouyan ,
Fatemeh Mohammadi  and
Mehdi Moghaddasi
Mansoureh Mamarabadi
Affiliation:
Rasool Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hadie Razjouyan
Affiliation:
Department of Medicine, Howard University Hospital, Washington, DC, USA
Fatemeh Mohammadi
Affiliation:
Rasool Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mehdi Moghaddasi*
Affiliation:
Rasool Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
*
Rasool Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Optic Neuritis (ON) is one of the most common clinically isolated syndromes which develops into clinically diagnosed Multiple Sclerosis (CDMS) over time.

Objective:

To assess the conversion rate of Iranian patients presenting with idiopathic ON to CDMS as well as monitoring potential demographic and clinical risk factors.

Methods:

Atotal of 219 patients' medical records of idiopathic ON from March 2001 to May 2009 were reviewed. Demographic findings, ophthalmologic characteristics on admission and discharge, diagnostic approaches, type and dosage of therapy were retrospectively reviewed. A structured telephone interview was then conducted to identify patients who had subsequently been diagnosed with MS. Survival analysis was used to evaluate the cumulative probability of MS conversion and contributory risk factors.

Results:

From the 219 ON patients, 109 [age 11-51, female: 81%] were followed up. Among the male gender the mean age of patients developing MS was significantly lower (P=0.01). In cox regression model, female sex (p=0.07), bilateral ON (p=0.003), MRI abnormalities (p <0.001) and high dose (5g) corticosteroid therapy (p<0.001) were identified as risk factors for the development of MS. The two and five year cumulative probability of developing MS were 27% and 45%, respectively.

Conclusions:

Idiopathic ON in Iranian patients carries higher risk of progression to MS compared to other Asian countries. MRI lesions are the strongest independent risk factor of developing CDMS. Bilateral ON, female gender and high dose corticosteroid therapy are also important factors in predicting CDMS development.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 6 , November 2011 , pp. 887 - 895
Copyright
Copyright © The Canadian Journal of Neurological 2011

References

1.Noseworthy, JH, Lucchinetti, C, Rodriguez, M, Weinshenker, BG.Multiple sclerosis. N Engl J Med. 2000; 343(13):938–52.Google Scholar
2.Ramagopalan, SV, Dobson, R, Meier, UC, Giovannoni, G.Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol. 2010; 9(7):727–39.CrossRefGoogle ScholarPubMed
3.Milo, R, Kahana, E.Multiple sclerosis: geoepidemiology, genetics and the environment. Autoimmun Rev. 2010; 9(5):A387–94.Google Scholar
4.Poppe, AY, Wolfson, C, Zhu, B.Prevalence of multiple sclerosis in Canada: a systematic review. Can J Neurol Sci. 2008; 35(5): 593–601.CrossRefGoogle ScholarPubMed
5.Beck, CA, Metz, LM, Svenson, LW, Pattern, SB.Regional variation of multiple sclerosis prevalence in canada. Mult Scler. 2005; 11(5):516–9.Google Scholar
6.Miller, D, Barkhof, F, Montalban, X, Thompson, A, Filippi, M.Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis. Lancet Neurol. 2005; 4(5):281–8.Google Scholar
7.Fisniku, LK, Brex, PA, Altmann, DR, et al.Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis. Brain. 2008; 131(Pt 3):808–17.Google Scholar
8.Nilsson, P, Larsson, EM, Maly-Sundgren, P, Perfekt, R, Sandberg-Wolheim, M.Predicting the outcome of optic neuritis: evaluation of risk factors after 30 years of follow-up. J Neurol. 2005; 252(4):396–402.Google Scholar
9.Corona-Vazquez, T, Ruiz-Sandoval, J, Arriada-Mendicoa, N.Optic neuritis progressing to multiple sclerosis. Acta Neurol Scand. 1997; 95(2):85–9.Google Scholar
10.Francis, DA, Compston, DA, Batchelor, JR, McDonald, WI.A reassessment of the risk of multiple sclerosis developing in patients with optic neuritis after extended follow-up. J Neurol Neurosurg Psychiatry. 1987; 50(6):758–65.Google Scholar
11.Ghezzi, A, Martinelli, V, Torri, V, et al.Long-term follow-up of isolated optic neuritis: the risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests. J Neurol. 1999; 246(9):770–5.Google Scholar
12.Ebers, GC, Sadovnick, AD, Dyment, DA, Yee, IM, Willer, CJ, Risch, N.Parent-of-origin effect in multiple sclerosis: observations in half-siblings. Lancet. 2004; 363(9423):1773–4.CrossRefGoogle ScholarPubMed
13.Hirst, C, Ingram, G, Pickersgill, T, Swingler, R, Compston, DA, Robertson, NP.Increasing prevalence and incidence of multiple sclerosis in South East Wales. J Neurol Neurosurg Psychiatry. 2009; 80(4):386–91.Google Scholar
14.Alonso, A, Hernan, MA.Temporal trends in the incidence of multiple sclerosis: a systematic review. Neurology. 2008; 71(2):129–35.Google Scholar
15.Hedstrom, AK, Baarnhielm, M, Olsson, T, Alfredsson, L.Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis. Neurology. 2009; 73(9):696–701.Google Scholar
16.Hawkes, CH.Smoking is a risk factor for multiple sclerosis: a metanalysis. Mult Scler. 2007; 13(5):610–5.Google Scholar
17.Kurtzke, JF.Geographic distribution of multiple sclerosis: An update with special reference to Europe and the Mediterranean region. Acta Neurol Scand. 1980; 62(2):65–80.Google Scholar
18.Kampman, MT, Brustad, M.Vitamin D: a candidate for the environmental effect in multiple sclerosis - observations from Norway. Neuroepidemiology. 2008; 30(3):140–6.Google Scholar
19.Munger, KL, Zhang, SM, O’Reilly, E, et al.Vitamin D intake and incidence of multiple sclerosis. Neurology. 2004; 62(1):60–5.Google Scholar
20.Willer, CJ, Dyment, DA, Sadovnick, AD, et al.Timing of birth and risk of multiple sclerosis: population based study. BMJ. 2005; 330(7483):120.Google Scholar
21.Lin, YC, Yen, MY, Hsu, WM, Lee, HC, Wang, AG.Low conversion rate to multiple sclerosis in idiopathic optic neuritis patients in Taiwan. Jpn J Ophthalmol. 2006; 50(2):170–5.CrossRefGoogle ScholarPubMed
22.Optic Neuritis Study Group. Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up. Arch Neurol. 2008; 65(6):727–32.Google Scholar
23.Kazim, SF, Islam, M, Khan, M, Hameed, B, Shafqat, S.Risk of multiple sclerosis after idiopathic optic neuritis in a Pakistani population. Can J Neurol Sci. 2010; 37(2):258–63.Google Scholar
24.Balashov, KE, Pal, G, Rosenberg, ML.Optic neuritis incidence is increased in spring months in patients with asymptomatic demyelinating lesions. Mult Scler. 2010; 16(2):252–4.Google Scholar
25.Beck, RW, Arrington, J, Murtagh, FR, Cleary, PA, Kaufman, DI.Brain magnetic resonance imaging in acute optic neuritis. Experience of the Optic Neuritis Study Group. Arch Neurol. 1993; 50(8): 841–6.Google Scholar
26.McDonald, WI, Compston, A, Edan, G, et al.Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50(1):121–7.Google Scholar
27.Polman, CH, Reingold, SC, Edan, G, et al.Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol. 2005; 58(6):840–6.CrossRefGoogle Scholar
28.Sellebjerg, F, Nielsen, HS, Frederiksen, JL, Olesen, J.A randomized, controlled trial of oral high-dose methylprednisolone in acute optic neuritis. Neurology. 1999; 52(7):1479–84.Google Scholar
29.O’Riordan, JI, Thompson, AJ, Kingsley, DP, et al.The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up. Brain. 1998; 121 (Pt 3):495–503.Google Scholar
30.Amirzargar, AA, Tabasi, A, Khosravi, F, et al.Optic neuritis, multiple sclerosis and human leukocyte antigen: results of a 4-year follow-up study. Eur J Neurol. 2005; 12(1):25–30.Google Scholar
31.Hutchinson, WM.Acute optic neuritis and the prognosis for multiple sclerosis. J Neurol Neurosurg Psychiatry. 1976; 39(3): 283–9.CrossRefGoogle ScholarPubMed
32.Jacobs, LD, Kaba, SE, Miller, CM, Priore, RL, Brownscheidle, CM.Correlation of clinical, magnetic resonance imaging, and cerebrospinal fluid findings in optic neuritis. Ann Neurol. 1997; 41(3):392–8.Google Scholar
33.Vedula, SS, Brodney-Folse, S, Gal, RL, Beck, R.Corticosteroids for treating optic neuritis. Cochrane Database Syst Rev. 2007; 24(1): CD001430.CrossRefGoogle Scholar
34.Isayama, Y, Takahashi, T, Shimoyoma, T, Yamadori, A.Acute optic neuritis and multiple sclerosis. Neurology. 1982; 32(1):73–6.Google Scholar
35.Hely, MA, McManis, PG, Doran, TJ, Walsh, JC, Mcleod, JG.Acute optic neuritis: a prospective study of risk factors for multiple sclerosis. J Neurol Neurosurg Psychiatry. 1986; 49(10):1125–30.CrossRefGoogle ScholarPubMed
36.Rizzo, JF 3rd, Lessell, S.Risk of developing multiple sclerosis after uncomplicated optic neuritis: a long-term prospective study. Neurology. 1988; 38(2):185–90.CrossRefGoogle ScholarPubMed
37.Soderstrom, M.Optic neuritis and multiple sclerosis. Acta Ophthalmol Scand. 2001; 79(3):223–7.CrossRefGoogle ScholarPubMed
38.Rodriguez, M, Siva, A, Cross, SA, O’Brien, PC, Kurland, LT.Optic neuritis: a population-based study in Olmsted County, Minnesota. Neurology. 1995; 45(2):244–50.Google Scholar